Patellofemoral Joint Pain
Updated: Feb 27, 2019
Hi Guys, our topic for this week is patellofemoral joint pain, or pain that comes from the knee cap.
The reason we want to talk about this today, is that it links in very closely and can be caused by the some of the same issues as our earlier topics plantar fasciitis and Achilles tendinopathy.
As mentioned the patella is the technical name for your knee cap. The patellofemoral joint sits at the front of the knee and is the joint between the knee cap and the big thigh bone, the femur.
Patellofemoral joint syndrome refers to a problem that occurs in this joint when the knee cap and the femur rub on each other. It can be referred to by several different names, such as patellofemoral joint syndrome, patellofemoral joint pain syndrome, patellofemoral pain syndrome, patellofemoral maltracking and the list can go on. But essentially any pain arising from the knee cap can be referred to as patellofemoral joint syndrome.
So how does it occur. PFJS has numerous contributing factors and is usually caused by a biomechanical imbalance at the knee. The patella is a floating bone, controlled by the pull of the muscles on the outside of the knee versus the muscles on the inside of the knee. You’ll notice when the knee is straight you can wobble the knee cap a lot, but when it is bent it barely moves at all. This is because the more we bend the knee the further the knee cap moves into the groove between the femoral condyles.
The problem in PFJ is that the outside muscles are much larger and stronger than the inside muscles and can easily override them, pulling the knee cap toward the outside of the knee.
Now the underside of the patella has a small ridge on it, and it is supposed to glide back and forth in the groove between our femoral condyles. When the outside muscles pull the patella in a lateral direction it causes a change in this tracking resulting in the ridge rubbing on the inside of the femoral condyle, this causes areas of greater pressure and with activities that require repetitive bending and straightening of the knee causes irritation, giving rise to pain and inflammation.
To complicate things more, often, particularly if you get pain in both knees, the underlying cause can be coming from the feet or the hips, but that’s a discussion for another day.
The signs and symptoms of PFJS are pain that is located either around the knee or below the patella at the front. There may be a grinding (crepitus) feeling, or occasional popping of the knee and sometimes it will feel like there is sand in the knee.
Movements where repetitive knee bending is required, particularly in a loaded position, tend to aggravate the pain. This might include running, jumping, hopping, going up and down stairs, squatting, kneeling and sitting for prolonged periods.
The good news is, is that PFJ pain in readily treatable. A treatment plan consists first of eliminating the pain, then restoring flexibility to the muscles on the outside of the knee mobilising the knee cap back to its central position before strengthening the muscles on the inside to hold it in place. A thorough treatment plan should also look at other causative factors such as your foot position and hip control and correction of these to ensure lasting relief is found.
As always, we believe that prevention is better than cure. So here are a couple of tips to help minimise the chance of patellofemoral joint problems occurring in the first place:
1. Invest in and use a pair of good, supportive shoes à at all times. We can’t recommend this highly enough. Your feet are the lowest part of your body and must support all of your bodyweight, so if they aren’t aligned it can have an effect on everything that sits on top of it, especially the knee.
2. Make sure you stretch or roll your Iliotibial Band (ITB) to prevent it from becoming excessively tight. Check back through some of our earlier videos which cover ITB rolling.
3. Engage in a good quadriceps, hamstring and calf stretching routine before and after any exercise to reduce the load through the PFJ.
If you do feel any of the symptoms we outlined above, then consult your healthcare practitioner sooner rather than later.
So, there you have it! That’s a quick overview of patellofemoral joint syndrome. If you have questions or comments feel free to e-mail us at firstname.lastname@example.org and we will happily answer them for you.
If you think you may already be suffering from patellofemoral joint syndrome and want relief now then call us on (08) 9486 8653 and we will arrange an appointment for you.